Wound Vac - help me help my mom

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Specializes in Med/Surg.

About 6 wks ago, my mother injured her foot badly in a disagreement with a lawnmower blade.

The skin over the repaired tendon isn't healing well, and she's having surgery tomorrow to either apply a vac or a 'plug/flap'.

She isn't diabetic and is in generally good health, though thin and a long-time smoker. Her skin is thin and fragile. I'm looking for suggestions RE nutrition and anything I (a non-nurse currently taking prereqs) can look for or do to help.

TIA

Specializes in ER.

Stop smoking. It damages the smallest capillaries and prolongs healing. Warm packs will increase the circulation, protein to build the tissue.

Probably some of our naturopathic nurses can help too.

Specializes in ICU/CCU/MICU/SICU/CTICU.

High protein and high vitamin C.

Specializes in Med/Surg.
High protein and high vitamin C.

Thanks for the thoughts. I'll be heading out there early tomorrow.

Specializes in ICU/CCU/MICU/SICU/CTICU.

You're welcome. Another thing, if her skin is thin and they place a wound vac on her......... make sure they use LOTS of skin protectant. The transparent dressing that is used with wound vacs can be rough on the skin. The skin protectant will help with the dressing changes and help to keep the skin from becoming irritated.

I would suggest that she actually sees a physician whom specializes in wound care. They may have some alternatives to the wound vac. I could ask numerous questions about the type of wound but this could be a long response then. Does it drain much, what type of wound exactly. what are the current treatments that they are doing etc, has she had recent lab work and as the other posters stated is her nutrional value good ie vitamins C, E and Zinc. Is the affected area getting worse, or is it just slow to heal?

Stopping smoking is also important increase blood flow to the affected area. Some additional testing may be needed to check blood flow to the affected leg, venous dopplers or what they calll at the facility I work a TCOM in which they check oxygen flow to the leg. These all check to see if blood flow is adequate for tissue perfusion and healing.

Another alternative if you have one in your area is a hyperbaric oxygen tank which is used to treat wounds by using pressurized 100% oxygen.

Good luck to your mom and keep in touch.

Specializes in Med/Surg.

Well, she has the wound vac. I probably couldn't answer detailed questions about the wound itself (back of the heel, over the tendon). The home health nurse initially said she didn't think it was deep enough to put the VAC on it, but that's what the surgeon did.

She eats like a bird. Toast and coffee in the a.m., and pretty good meals really for the other two, just not in large amounts. No wonder she stays so thin. I encouraged juice and milk without much success. She is taking a multivitamin. If she smoked at all while I was there (5 days), it was only once. She had cut back dramatically over the last 2-3 years anyway.

She's pretty discouraged. Apparently the doctors only share negative views -- all the bad things that could happen (up to and including amputation). The nurses from the home health agency were much more encouraging and told her they think she will be pleasantly surprised by how well this works. She's afraid of more surgery, that they'll end up grafting skin anyway, or that the worst (amputation) will happen. I think sometimes she wonders if she'll even live through all this, but maybe that's just general discouragement. My mother is accustomed to being very independent, and this has been emotionally hard on her. (and on my dad, too).

A friend of hers called to tell her that her (the friend's) husband was being treated with hyperbaric therapy. Mother's reluctant to ask the doctors, but did ask the nurses what they knew about it, and they said they thought her wound wasn't "bad enough" for that yet.

I'm hopeful, but feel completely helpless to do anything to help except try to be encouraging and push eating good foods. After all the blood tests, chest x-rays, and an EKG prior to this surgery, she was told how healthy she is, so I guess that's a good sign. The only thing brought up at all was a slightly low potassium level, so she's eating about 1/2 a banana a day.

Specializes in Vents, Telemetry, Home Care, Home infusion.

Needs more protein for wound healing: nibbling on cheese, 1/2 meat sandwich, cream soup,milkshake, even glass of milk will help.

Resource makes a shake with Arginine that helped my Dad heel from toe necrosiss due to blood clot in leg post triple A repair. Dr swore amputation would occur-- skin over toe sloughed off with new growth skin; never would guess he had a wound! Had GREAT nurses from my homecare co.

http://www.novartisnutrition.com/us/productDetail?id=52

My agency uses ton of vacs with pretty good results.

Good luck!

A graft might happen, but is not necessarily a bad thing. See it all the time. Try to let your mom know that a great attitude really goes a long way, along with all the other great advice listed here. Keep up with the vitamins, down with the smokes and a VAC can do wonders. I have seen great things with them.

Specializes in Vents, Telemetry, Home Care, Home infusion.

additional info:

advances in skin & wound care: arginine and wound healing: a case ...

available arginine-enriched beverages include resource arginaid and resource

arginaid extra (novartis nutrition, minneapolis, mn) and juven (mti biotech, ...

www.findarticles.com/p/articles/ mi_qa3977/is_200403/ai_n9366183

peanuts, which are cheap and readily available worldwide, contain 1 gram of arginine per 30 grams

http://www.oncolink.com/resources/article.cfm?c=3&s=8&ss=23&id=9454&month=03&year=2003

nut is best but peanut butter crackers/sand great too!

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